Elements of the patient-centered medical home in family practices in Virginia

Document Type

Journal Article

Publication Date



Annals of Family Medicine


Volume 7, Issue 4

Inclusive Pages



Delivery of Health Care--organization & administration; Family Practice--organization & administration; Patient-Centered Care--organization & administration; Health Administration/Organization; Hospital Services; Primary Care; Community Health Centers; Performance Measurement; Patient Needs


PURPOSE The patient-centered medical home (PCMH) is a widely accepted
theory of a practice model to improve quality of care, patient satisfaction, and
access to primary care services. This study explores existing elements of the
PCMH and characteristics of family practices in Virginia.

METHOD We developed and administered a survey questionnaire to capture
information on practice characteristics and PCMH elements. We randomly
sampled 700 family medicine offi ces in Virginia from a population of practices
derived from the Virginia Board of Medicine Practitioner Information Database.
We used a mixed-mode survey, allowing practices in the sample to respond by
mail or Internet or at a regional family medicine conference.

RESULTS The survey resulted in a response rate of 56%, with 342 offi ce locations
participating in the study. Most practices reported continuity-of-care processes
(87%) and clinical guidelines (77%). Fewer reported use of patient surveys
(48%), electronic medical record for internal coordination (38%), community
linkages for care (31%), and clinical performance measurement (28%). A small
number reported patient registries for multiple diseases (19%). Very few practices
exhibited all elements outlined in the PCMH model (1%). Practice size (number
of physicians) is signifi cantly related to PCMH model alignment.

CONCLUSIONS Most family practices in Virginia exhibit some elements of the
PCMH model. Full implementation of the PCMH model is low. Baseline information
on practice characteristics, prevalence of PCMH, and challenges of small
practices should be considered in guiding efforts, evaluating progress, and developing policies for care model reform.


Erratum in

Ann Fam Med. 2009 Sep-Oct;7(5):467.

This is a PubMed Central article. Click on link for full-text access.

Open Access